My Ketogenic Life: Year One

On February 24, 2013, I weighed in for the beginning of a little experiment. About four months after learning I have a grade two brain tumour, I’d finally marshalled my mental resources and done some reading. I also made use of the expertise of a few valued coworkers and friends who are cancer and metabolic health researchers. I basically tasked a couple of these fellows with doing some reading for me, and telling me the stuff I needed to know, but nothing negative that was not actionable. I found I needed that small degree of shielding from the internet.

I learned that there is a lot of good research out there that builds on foundational work done in the 1920’s by Nobel laureate Otto Heinrich Warburg, now referred to as the Warburg Hypothesis. Essentially, Warburg observed that a key difference in cancer cells compared to normal cells is that the way they generate energy for growth and reproduction is altered, replacing the way normal cells use oxygen, with fermentation of sugar. Although Warburg won a Nobel prize, much of his work was set aside as not causal of cancers, but perhaps just a side-effect. Also, in the 80’s and 90’s, we saw the rise of genomics and the Human Genome Project, which held a sexy promise of curing disease through the unravelling of the secrets of the genetic code of life.

In recent years, interest in Warburg’s work has been renewed, including research on cancer as a metabolic disease. I’ve referred before on this blog to the work of Dr. Thomas Seyfried of Boston College, which is really the key information I found online that pointed me in the direction of the ketogenic diet. It was this presentation from Dr. Seyfried that set me feverishly to work trying to understand the ketogenic diet and whether it was something I could reasonably incorporate into my lifestyle.

In my initial research, I meandered through information and cookbooks about Paleo and Neolithic diets and Atkins diets. These are all variations on the low carbohydrate theme. What I had learned from my research, however, is that what I wanted, in a nutshell, was a diet high enough in fat and low enough in sugar that my body would be forced to adapt and use fat for energy. It is worth noting that I did not do this in cooperation with a dietician or doctor. I do have a background in biology and health research, and a lifelong interest in fitness and diet, so after doing my research, I felt the changes I was prepared to make were not extreme enough to require actual medical supervision. Judge that as you may.

The ketogenic diet has been used successfully as a medical intervention in children with refractory seizure disorders that do not respond to medication. That means a lot of the information found online deals with epilepsy. This is what I focused on, as opposed to diet plans that were more clearly designed for weight loss exclusively, for example. The goal is to obtain about 65% of daily calories from fats (including the saturated fats that we’ve all been taught to fear), 30% of daily calories from protein, and only about 5% from carbohydrate sources. You’ll find different breakdowns, but that’s generally in the ballpark across sources I’ve seen. Another piece of advice I encountered and took to heart was that you should try to eat no more than 50 to 100 grams of carbohydrate per day, and then make up all the food you need for the day from fat and protein sources, with a focus on the fats.

Why, you ask? The idea is that on a regular North American diet (think traditional food pyramid, with breads and starchy carbs as the base), glucose is a major energy source in your body, and is transported in your blood to fuel your brain. If you eat no sugar, but high fat, the fat you consume is not stored. Rather, your liver converts it into something called ketone bodies, which can be used by cells in your body for energy instead, and can pass into the brain and be used as an energy source for brain cells as well. It turns out that brain cells love using ketones for energy; some of the leading proponents of this diet as a lifestyle claim improved mental function, even higher IQ, on a ketogenic diet. The underlying idea as it pertains to cancer, particularly brain tumours, is that cancer cells are somewhat primitive from a metabolic perspective, and they love to use sugar for energy. When sugar is unavailable, other brain cells can convert to use ketones, but cancer cells aren’t this agile, so the idea is that they start to “starve” for energy, slowing growth.

This brings me to February 24, 2013. On that date, I started a ketogenic diet, and started collecting my own data. For the past year, I’ve weighed in using a home body fat scale on a weekly basis, and measured my blood ketones using a ketone meter. Hey, I’m a bit of a data nerd, okay? My initial concern, having been inculcated into the low fat way of thinking over most of my adult life, was that I would, quite simply, get fat. This diet is high fat, adequate protein, low (or no) carb. I viewed low carb diets as fads that I’d encountered in fitness circles for years, and I am extremely skeptical of any diet fad. Even ones that last for decades, like Atkins. But what it came down to, is that I figured eating a diet high in saturated fats for a few months was probably not as risky as a burgeoning brain tumour, so I felt pretty relaxed about it. This is info for another day, but I also started to tune into information like Gary Taubes’ excellent New York Times piece entitled “What if It’s All Been a Big Fat Lie?”, which made me rethink my perspective on dietary fats altogether.

I ate eggs, bacon, and a dollop of full fat sour cream for breakfast. I got weird looks at Starbucks or my local neighbourhood espresso bar when I ordered my sugar free latte prepared with heavy cream. I ate my own weight in avocadoes and was pleased to find that with the explosion in popularity of the Paleo diet, my local Costco carried giant tubs of coconut oil. With gluten-free diets becoming more prominent, I discovered that Bulk Barn was teeming with nut flours and other ingredients I’d never had cause to seek out.

The results, so far: in the past year, I lost 13.4 lbs. Percentage-wise, my body fat decreased by 5.3%, and my muscle mass increased by 1.7%. This translates into 8.5 lbs of body fat lost, and 3.3 lbs of muscle lost. I started out at 118.2 lbs, 22.1% body fat, and 37.8% muscle mass. So I didn’t have much weight to lose, of course. And this was not a weight loss experiment. But I have been continually surprised that with this kind of diet, I was not gaining weight at all. In fact, I was getting leaner. As someone with a life long interest in health and diet, and a fitness instructor, I also find it of note that I did not take any measures to preserve muscle mass. I do yoga once a week and go for some walks, if I’m honest. I’m not on any regular workout program right now. So I was not working along the way to increase or maintain muscle mass. And yet, although 3 of the 13 lbs I lost are muscle mass, in terms of percentage body composition, my muscle mass now comprises a larger portion of my weight. This is referred to as “lean mass” and is considered in fitness circles to be a good thing. I will say that these measurements were taken with a home scale; these are well known for not necessarily being absolutely accurate, quantitatively. This means that if a professional measured by body fat percentage, it might not come out to the same exact number as on the scale. But they are accepted to be pretty accurate at measuring change. So if I saw a 5% decrease in body fat, this is likely to be fairly accurate.

I did measure blood ketones, using a finger prick method and an Accuchek meter. I used guidelines found broadly in ketogenic resources, with the target being 0.5 to 3 mmol/L. It took me about four weeks to get into that range; my normal diet had my ketones sitting around 0.1 most mornings. I took these measurements on an empty stomach every morning. After the first three weeks, I saw regular measurements around 1.5 to 2 mmol/L fasted in the morning like that, which I felt was the target. I also noticed around that time that my energy was up and brain fog was clearing, both problems I’d read would occur during the first weeks of adjustment until my body got used to using ketones for fuel. I continued to measure my blood ketones while I played with the diet a bit, to fine tune things, but found that getting up to 2.5 mmol/L in the morning was rare, and I seemed to settle in at around 1.9 or 2 always after a couple of months, after which I stopped pricking my finger every day.

What have I learned? Well, I didn’t get fat because I ate fat. I don’t miss carbs as much as I thought I would, and I was a carb-aholic, no joke. I’ve always been lucky to not struggle with weight, so I’ve never had to stick strictly to a diet, and I learned that I can. I don’t even feel tempted to cheat, for the most part. I just think of my brain tumour, growing fat and happy on pasta and croissants, and I find it easy to pass them by. For what it’s worth, anecdotally, I haven’t been down with sniffles or a virus in a year, I think my immune system is stronger. I can see ribs and abs that I didn’t before. My husband says he thinks I’m healthier than I was a year ago, hands-down. I’ve never really considered myself a “cook” or “baker” but now I do both (bitter irony). My last MRI in October, six months into the diet, showed no change in my tumour. While I was a little sad it wasn’t shrivelled up altogether, I’ll take this as a “no news is good news” scenario.

They say a good diet is one that you can be on for the rest of your life. I think this fits the bill for me.

Some tips, if you’re interested in doing your own research, which I encourage:

There are a lot of low carb diets out there, don’t be overwhelmed by the variety. Look for “ketogenic” or “low carb/high fat” or #LCHF.

The current prominence, in particular, of Paleo diets is an advantage, because it makes so many recipes and ingredients more available; just know the difference. Watch out for the Paleo friendly carbs such as sweet potatoes, which can add to your daily carb count in a hurry.

I know navigating the idea of eating high fat is difficult to understand, or it was for me. The Keto Diet App blog linked above just posted this fabulous guide to dietary fats.

I have just become aware of this website, Ketogenic Diet Resource, which is very well written and very comprehensive, and includes sections by health concern (added 13 March 2014).

Obligatory disclaimer – these have just been my experiences, I am not a doctor, I am still a learner, I am not a promoter of any of these products, books, or blogs and am not receiving anything in return for listing them here.

We gave animals unrestricted ketogenic diets and the tumor cells grew just as fast, or even faster sometimes, than a standard high-carbohydrate diet. So we said, what’s going on here? There’s a diet with zero carbohydrate and the animals are eating as much as they want and when we looked at their blood, their blood sugars were very high. So it turns out if you eat large amounts of fat in a ketogenic diet you get insulin insensitivity, which then increases the level of sugar, and the cancer cells are fat and happy using this. So you have to restrict the diet.

There are some people out there, like any media thing, they’ll say, “Oh, the ketogenic diet cures cancer.” We know there’s no evidence for that. We haven’t used it long enough to know if anybody is going to be cured from cancer using a ketogenic diet. All we can say is that the ketogenic diet has the potential to arrest the growth of the tumor.

Thanks for this information and comment, Albie, this is valuable. There is also a lot of research out there on calorie restriction and the effect on things like health and inflammation of not “eating as much as you want”, but maintaining a calorie limit. I think you’ve hit on a very important point in terms of not believing something like cancer can be “cured” by something as simple as a dietary change. This is certainly very elementary thinking and is a perfect example of one of the pitfalls of online research that I’ve found time and again: you have to be health literate to think critically about what you’re reading, or you just end up chasing every supplement and berry out there! Thanks for your comments.

“I think you’ve hit on a very important point in terms of not believing something like cancer can be “cured” by something as simple as a dietary change.”

I don’t think even Seyfried asserts that (and I’ve read his book). However, arresting tumor growth, without toxic treatments, while awaiting a more complete answer, is more progress than we’ve seen from the Somatic Theory camp, who are reportedly being very quiet about emerging unhappy news on that front, see:http://robbwolf.com/2013/09/19/origin-cancer/

If the genetic chaos in cancer is a consequence of the underlying disease process, and not the cause, effective gene therapies are going to be all but impossible to develop.

It is important to critically examine all developments, from all sources, whether they support a preferred conjecture or not. We have seen too many disappointing miracle cancer cures over the last several decades (interferon anyone?). Real trials of unconfounded restricted-calorie ketogenic diet (R-KD) are going to take a long time to produce results, largely due to expense, restrictive protocols, liability and a near total lack of patent opportunities.

The convenient thing about R-KD therapy is that people can choose to do it on their own. I would imagine that anyone with a diagnosis, who intends to decline chemo/rad, and is aware of R-KD, would try it. Alas, whatever results they get are “mere anecdote” and not data. If the result is arrest or remission, that person probably doesn’t care what consensus medicine thinks.

I think the calorie restriction being necessary was an artefact of the animals being rodents. Humans are more easily ketogenic, and less likely to need that. Moreover, calorie restriction is difficult and miserable, and I suspect it caused unnecessary failure in case studies becuase of inability to adhere.

Even Seyfried is coming to this view, if only in certain cases:

“TS: You know the issue is, how long should you do this? I have to admit in some of my earlier publications, we were pretty hyped on the calorie restriction aspect of it. We were probably going a little overboard on how many calories you need to restrict. Only after we saw rather substantial regression of tumors or stabilization in people who cut down to maybe 1500 calories a day, which is not anywhere near a heavily restricted diet, did we begin to see that each individual is a unique metabolic entity. Some people require minimal restriction and other people require more restriction. If you look in the literature, a lot of people are using ketogenic diets to remain in a healthy state at low weight. And people can maintain this for years and they seem to be very healthy. Now I’m not saying all cancer patients need to maintain for the rest of their lives a state of low glucose and elevated ketones. I suggest they do it until there is clear evidence that the disease has been arrested or stabilized. And then there’s a likelihood one could transition off of this, as they would for any kind of therapy.” –from an interview http://www.townsendletter.com/Jan2014/warburg0114.html

Seyfried also said in an interview last summer that he is beginning to think the CR is not always necessary to reach his “metabolic zone of therapy” where glucose and ketones are around a 1:1 ratio. It’s all in those numbers, CR being necessary only if one isn’t hitting them on a VLCHF diet.

Thank you for sharing this story. I, too, am sorry to hear that the tumor didn’t already shrivel to nothingness. But, like you said, it seems like you’ve found a diet that you can stay on for life, and it is probably helping you against the tumor. You may be interested in our blog: http://ketotic.org .

Have you tried checking your ketone levels in the evening? In contrast (sometimes) to blood glucose, on a strict ketogenic diet, ketones seem to be higher at night than in the morning (even if you test fist thing on an empty stomach). Just a suggestion. You might notice higher levels at night.

TuitNutrition, this is a good point. No, I didn’t try testing at other times during the day. I’d read that blood levels will go up after a high fat meal, and throughout the day would be variable. The scientist in me wanted to control for those variables, and I kind of just thought that if the first morning levels were in the zone, so to speak, I’d be good to go for the rest of the day. And to be honest, I am not enough of a data junkie to want to bloody my fingers multiple times per day! Lots of people have done that, I’d seen their data online, and was willing to go with the first morning approach!

You are amazing for keeping this blog up and sharing your story. Thank you! I also read that the “rat chow” that was being used in the unrestricted ketogenic diet was a standard factory blend of the worst kind of cheap, rancid fats – soy and canola for example – which would be inflammatory and mitochondrial damaging in their own right. The “rat chow” is not really ideal for rats, and certainly not idea for humans even if the macro nutrient percentages were “correct”. It is always going to matter WHAT the food is just as much as what the macro and micro nutrient content is. Unfortunately this did not get studied. My hopeful assumption is that if the rats were fed an appropriate amount of natural protein (for a rat), with natural fats (lard from naturally raised pigs, for example) and restricted carbohydrates (from seeds or something equally “natural” to a rat), the scientists might have come up with different results (i.e., better results). It’s hard to say whether restricting the calories helped because of lowering the calories, or because it lowered the amount of inflammatory agents allowed in the diet. I will try to find my source for the rat chow info and get back to you. Thanks again.

Also, I noticed you said you wanted to keep your daily carbohydrates to between 50 – 100g. I really don’t mean to criticize, because you have done an incredible job so far and are really inspiring me, and you have a brain tumor for god’s sake… But I just wanted to know, out of pure scientific interest, if you had tried doing a water fast, or a fat-only fast (like a coconut oil fast), or at least a zero-carb fast for any period of time? And if not, I guess I am also wondering if you are working up to it or what your thoughts are. My interpretation of Seyfried’s work is that you need under 10g carbs/day to reverse tumors, and possibly limited protein to reduce glycogenesis. ???

Hi, Sofa King! Thanks for both of these above points and for reading. For me, Seyfried was the first work I found that just set me off on the path of looking at the ketogenic diet as an option. A lot of other reading I did suggested it might be beneficial for neurological conditions beyond epilepsy, and to be honest, I sort of thought it couldn’t hurt! In my day job, I work at a metabolic research company, and we sort of generally find that animal studies really don’t always translate that well into humans, so I didn’t focus too much on the details of the rat diet or the specifics of grams of carbs, to be honest. I sort of designed my personal experiment based on the hypothesis that removing carbs as a significant source of energy and replacing with ketones may be beneficial, but that it had to be a real life, sustainable diet for me, so then I just jumped into research on ketogenic diets for athletes or daily living for kids with seizure disorders. I was looking for real world applications, as opposed to lab rat diets, or even the strict medically supervised fat mixtures they provide kids when switching to a ketogenic diet for seizures. So, in short, no, I didn’t do any fasting or oil only diets. My thinking here is that as long as I’m in a state of what they call “nutritional ketosis”, and that tumour is not advancing, I’m cool with that! I could live in my current state for another 40 years, on this diet, with a macadamia nut sized tumour sitting in my parietal lobe. I’m okay with that idea, so I haven’t been too focused on getting extreme to really try to reverse it, per se. That’s been my perspective so far!

Wow, I guess I didn’t think about that: that it does’t really matter if you have a macadamia-sized tumor – so long as it doesn’t progress. It doesn’t always have to be about reversing the tumor. Thanks for your thoughtful and honest reply. I suppose you could always keep a short period of fat fasting and zero-carbing up your sleeve, should things change. I think you have it under control though!

Hello Alix, I am the owner of the Ketogenic Diet Resource.com, and I’ve just recently released an ebook on how to use the ketogenic diet to manage cancer. It is based on Dr. Seyfried’s book but is written in less technical terms for the layperson. I would like to send you a copy if you are interested. Please email me and I would be happy to do this.

Hi, Ellen, I’m on my mobile at the moment, so I don’t have access to your full details I think. When I’m anchored again, I’ll email you, and would be pleased to read your book. I’m all for simplified communication on technical topics, I work in this area professionally as well, so I look forward to it!

I am sorry too, to hear that your tumor has not shrunk to oblivion. I was wondering if you could answer a couple of questions that have been lingering for me after reading your post. Do you have any autoimmune issues? With your new extremely low bodyfat, are your cycles regular? It is very rare for women to ever achieve such a low body fat percentage and I have never encountered someone who could maintain normal hormone levels while that low. I realize the abundance of dietary fats facilitates hormone function, so maybe this is providing a buffer for you? As an elite runner in college and post collegiately, I found I was able to initiate a menstrual cycle by increasing dietary fat percentage, while maintaining the same low body fat.

I would also love too know how you were able to bake on a ketogenic diet… Do you have any links or recipes you recommend?

Sorry for so many questions, you journey is inspiring and I wish you the best!

Hi, Dana, thanks for reading. Yes, I have regular cycles and have never seen a disruption. This would be different for different people of course, but most sources I’ve read will say problems like this will become common mostly down around 12% or lower.
In terms of “baking”, I’ve taken to making muffins, breads, crackers and things like that, once in awhile, using either a nut “flour” or flax meal. KetoDietApp has good recipes. My favourite five min breakfast muffin is http://www.food.com/recipe/one-minute-flax-muffin-low-carb-295649

Congrats! Your story is truly inspirational. I can attest to the improvements in mental acuity on a ketogenic diet. I was on the precipice of type 2 diabetes and failing to improve on a low fat diet. I found the documentary “Fat Head” and it was a game changer for me. I’ve been experimenting with making my own ice cream, so if you’re looking for some really tasty high fat/low carb food, you can check out my blog: http://gpinzone.blogspot.com/

Somehow via dr D`Agostino facebook page I came to your brave and truly informative blog.
I had first heard about dr Seyfried`s work from the wonderful la vida low carb show with Jimmy Moore and next the lecture at an Ancestral Health Symposium, fascinating celbiology, making great sense in coming away from the prevalent `everything is in the genes` dogma.
You are absolutely a 100% right this is the “collaborative media” era and I am thankful for it..
Wishing you so well with my warmest regards on this lovely crisp sunny day in the Netherlands. JB
ps
I was wondering whether you have followed Georgina Ede`s experience with Seyfried`s stringent diet protocol at Diagnosis Diet.com ? Not easy and for that matter not even being ill herself. To understand food stuff and all that, metabolism and cancer for me as a layperson she is the best educator I have ever come across.

I have read all the info on low carb/ Paloe/ and ketogenic dieast..and am still confuced..
Here’s why..and, when I ask this, generally I am told “there’s info on the internet..look it up”..
Well *that’s* why I *have* questions..and I’m hoping someone here will be kind enough to help me weed through all the hype and differing information, and give some *real* useful info..
My situation with low carb/ Atkins is *this*:
My husband was involved in a tragcic accident years ago..he was bed ridden for many months, it was a long, slow recovery..
During that time, he gained a LOT of weight (understandably..if you can’t walk..)
Prior to this accident, he was, and had always been very physically active..hiked, jogged, enjoyed doing property maintenence (we had a small farm)..
Also, (important) there is no history of heart disease in his family, on either side.
So, once he is able to start being active again, in stages..he wants to loose the weight he gained..
He tries the South Beach diet first..said he was always hungry on that…then tried the Atkins/ low carb thing..
He lost all the weight he gained from being laid up for those many months…didn;t get hungry..
He got back to being very active, as his condition improved..and, matter of fact, when he died, at age 48, he weighed what he weighed in high school..
Yes, I said he died….in his sleep, from a heart attack…this was completely unexpected..
When they did the autopsy, they found several partial and significant blockages, and his LAD (left anterior artery, commonly known as “the widow maker) was almost completely (98% or some such) blocked…along with an enlarged heart..and there was evidence of an earlier, minor heart attack, which the autopsy doc said could have been a few days before…and he may not have even been aware of it..
Along with the low carb/ high fat diet..he took all the “right” supplements…fish oil, CoQ10..etc…
Drank a lot of water…
So, you see my confusion about all this low carb stuff…
How could this man, very active, no history of heart disease in his family…drop dead in his sleep at age 48 from a heart attack???
I have no choice but to think the diet he was on caused it….
We didn’t eat “junk” before the accident and before he started the low carb thing…we had no “white” food (flour, sugar, etc) in the house and ate a mainly Mediterranean diet…
So…while i get that a diet that has a lot of carbs (grains, fruit, potatoes, carrots even, etc.) in it is not the best thing…I am scared to death of doing the Atkins/ ketogenic thing…because…look what happened to my husband…
I hope someone here can help me clarify things, and give me some *real* info (not merely anecdotal), I would very much appreciate it,,,and would start the regimine myself..

Hi, thanks for visiting my blog and sharing your story. I am sorry for your loss; your frustration is clear in your comment, thank you for taking the time to write it. I can relate to the feeling that there is so much information out there, and so much of it seems to conflict, and how that results in confusion. I am not a medical doctor, and cannot provide input on what may have contributed to your husband’s tragic early death. I can relate to how you feel about it. I often spend time in circular thought patterns, wondering what could have contributed to my medical condition. I also lost my father almost a year ago to an early onset form of dementia, and had the same experience. I spent a lot of time wondering what things may have contributed to his condition, and how unfair it was. For me, I’ve had to try very hard to “deprogram” those thoughts that drive me in circles regarding the past and the “when, why” of it all. That is much easier said than done. I try to be present in my situation today, and know that I’m safe and healthy right now.

In terms of planning for the future, I chose this diet based on information I’d read that I thought was from credible sources. I plan to do a blog post on how to understand scientific information you read, and how to think about whether a source is credible, because I think with so much information out there, finding the credible stuff is really the challenge. I’d say that if you’re scared to death of doing an Atkins-type diet, unless there’s a medical reason you think you should, there are lots of other healthy eating options out there that don’t involve something some people do consider “extreme”. I pursued the ketogenic path because I was pretty confident it wouldn’t be more dangerous than my brain tumour! That’s not for everyone, certainly.

Insofar as I’ve studied it, Atkins is only keto during Induction Phase. After that, the program allows carbs to be added back, and the diet doesn’t seem to have any particular awareness of the hazards of specific modern adverse carbs like wheat (and one of wheat’s many problems is exorphins, which trigger a form of addiction, often resulting in diet compliance failure).

For anyone averse to full nutritional ketosis, the way of eating detailed in Dr. Davis’ “Wheat Belly” series of books is both only borderline ketotic, and seems to hit all the correct notes on what to favor and avoid in diet (it is way far not just about wheat). Note that Davis is a cardiac specialist who has wound down his conventional practice because he’s saving far more lives with cookbooks. WB recipes can support deep keto with minor tweaks.

Is LCHF ideal for everyone? No. If you are ApoE2 or E4 genotype, you have a big problem with some fats, and your diet options are apparently quite challenging (on any type of diet).

I’m very sorry for your loss, I can imagine how you must feel about all this. It’s truly quite difficult to understand the truth and many websites and even studies are quite biased. I like articles from Chris Kresser, Mark Sisson or Robb Wolf. I’m careful with articles from Dr Mercola (they are mostly good but sometimes biased too).

In my opinion, low-carb diets may also be unhealthy. The perfect examples are Atkins products or various artificial sweeteners, bread and pasta products labeled “low-carb. These often contain what I would call “poison”.

I personally follow a paleo-friendly low-carb diet. This means I not only avoid eating high-carb foods but also make sure I pay enough attention to food quality (avoiding artificial sweeteners, processed foods like oils and inflammatory foods, soy, legumes, etc). I just try to eat real food and try to avoid packaged food if I can.

Hi Alix
I have done the same thing as you are doing, after being diagnosed with a grade 2/3 astrocytoma. It is inoperable due to its location, so I explored other options. I adopted a low carb high fat diet. This was in 2001, so I am living proof this can work!
All the best to you,
Rick

Two other novel tools to consider are hyperbaric therapy (which you probably know about from D’Agostino) and exogenous ketones (which is being proposed by Dr. Peter Attia, a pioneering investigator of nutritional ketosis).

Hello Alix, Edgar Cayce said that if you eat three almonds a day you will never die of cancer. I’m 64, have smoked 46 years, have taken 5 almonds daily for 33 years, and no problems. Five almonds have 32.2 calories; 2.8g fat; 1.2g protein; .6g net carbs (1.2 minus .6 fiber); and is packed full of vitamins and minerals. Now there is a worthwhile food.

> Edgar Cayce said that if you eat three almonds a day you will never die of cancer.

If his case is an example, I guess you get to die of stroke instead, at 68 🙂

Anyway, anyone on an LCHF diet is probably consuming at least the equivalent of 3 almonds a day, because they are in general compatible with the diet. Almond flour is perhaps the go-to alternative to wheat flour for those abandoning wheat. This, of course, would exclude those with a persistent allergy to almonds or nuts generally.

And, alas, almonds may become hard to get. In addition to increasing demand, the drought in California has devastated many almond groves. Our household uses a lot of almond flour, and prices have done nothing but rise steadily over the last 3 years.

On a generic low-carb or keto diet, counting calories is generally unnecessary. Counting carbs, however, is essential, as is monitoring actual results with a glycometer and keto strips. For most people, once they learn what to eat and avoid, counting carbs becomes optional too.

On a restricted calorie keto diet (R-KD), counting calories does become important.

> How do I count calories?

Read the Nutrition Facts or look up the raw food on the web.

In an unrelated matter …

I think I stumbled into the first exogenous ketone product on the market:http://prototypenutrition.com/ketoforce.html
Based on what Patrick Arnold obliquely said about this, it appears that this was formulated for Dr. D’Agostino’s cancer treatment experiments. It would be interesting to know if any cancer patients are trying it on their own to bump ketone levels as part of R-KD.

Boundless – I am very interested in this concept of exogenous ketones and what effect they might have. Having been on this diet for over a year, I find that with the same macro breakdowns, my blood glucose/ketone ratio is creeping up. It’s due to higher glucose, my ketone levels are the same as they were a year ago, once I was adapted. I wonder about insulin resistance, and whether boosting ketones is a good answer…

Greymadder: please keep us posted on creeping glucose numbers and control efforts. It’s something I’ve been wondering about for long term maintenance. Would cycling in higher carbs once every couple weeks make a difference? I’m interested because our son is battling brain cancer and we’ve had him on a KD since September. He’s doing great but I’ve heard about glucose numbers rising after a certain amount of time…

Hi, lila17. I eat between 1400 and 1500 calories a day. I’m late thirties, 103 to 105 lbs. This is on the low end of calories that might be recommended from a dietician, but maintains my weight. As Boundless wrote, I don’t really count calories daily, I just know how many I consume because I do keep an eye on my macronutrient breakdowns daily. That means watching how much fat/protein/carbohydrate I eat, to make sure I get enough fat, only moderate protein, and not too much carbohydrate. I use a handy iPhone app to track what I eat, and it spits out macronutrient and calorie breakdowns. There are many of these available, check out KetoDietApp or CarbManager on the app store.

I do measure blood glucose and ketones, using the Precision Xtra meter, which are handy data points to have in order to make sure you’re in a state of nutritional ketosis.

Thanks for mentioning my app! There will soon be all the features (tracking) also on the iPhone, not just the iPad app – we work on a universal version. It’s a lot of work but we will get there soon! 🙂

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Hi Greymadder, I am looking into this diet myself, as a woman with Stage 4 breast cancer. Have you read Elaine Cantin’s book/website? She has adapted the keto diet, based on her experience with her son’s Type 1 diabetes and her own cancer. She found that allergens caused rises in glucose, so has adapted her keto diet to be dairy-free, and even has one for vegans. As dairy is a major part of the general keto diet, yet is also implicated in causing cancer (see Jane Plant’s work), this might be something you’d like to look into further? Cantin believes that the problems Seyfried may be having with results are probably caused by allergens, which aren’t being taken into account. Her book “The Kantin Ketogenic Diet” is excellent – a really easy read, very factual. I am seriously considering starting her protocol soon.

Hi, thanks for reading. Yes, I’m familiar with her book and her program. I don’t eat a lot of dairy, although I’ve never found it to have an effect on my blood sugar, myself. If there’s one thing I’ve learned, it seems to be that one size doesn’t necessarily fit all!

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